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J Reconstr Microsurg 2014; 30(04): 275-278
DOI: 10.1055/s-0033-1361845
Letter to the Editor: Short Reports
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Upper Extremity Deep Vein Thrombosis and Pulmonary Embolus after Radial Forearm Free Flap: A Case Report and Literature Review

Joshua Wood
1   Department of Otolaryngology/Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
,
Jon Ver Halen
2   Department of Plastic and Reconstructive Surgery, Baptist Cancer Center/Vanderbilt Ingram Cancer Center, Memphis, Tennessee
,
Sandeep Samant
1   Department of Otolaryngology/Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
› Author Affiliations
Further Information

Publication History

15 September 2013

06 October 2013

Publication Date:
07 January 2014 (online)

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Background

Deep vein thrombosis (DVT) and its associated complications such as pulmonary embolism (PE) are well-known causes of morbidity and mortality in the surgical intensive care unit settings. The presentation, diagnosis, and management of lower extremity DVT (LEDVT) are well documented in the literature. However, the same is not true of those that occur in the upper extremities.[1] Upper extremity DVT (UEDVT) are less common than LEDVT , and usually asymptomatic until their complications arise. Risk factors for UEDVT differ from those of LEDVT, and include presence of a central venous catheter, cancer, and immobility.[1] [2] The first line therapy for UEDVT is systemic anticoagulation with low molecular weight heparin and long-term vitamin K antagonist therapy. Although less than in LEDVT, there is significant morbidity and mortality related to UEDVT, including PE and postthrombotic syndrome. We present a case of UEDVT that occurred in a head and neck cancer patient following relative immobility subsequent to radial forearm free flap harvest from his left arm.

 

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